Seniors in LTC at high risk of head injuries from falls

Seniors in long-term care facilities are at high risk of head injuries, with nearly 40% of those who fall striking their heads, according to a small study.

The researchers studied video footage of 227 falls among 133 residents at a pair of LTC facilities in the British Columbia province of Canada from April 2007 through June 2010. The video was taken by cameras installed in common areas of the facilities such as hallways, lounges and dining areas.

They found 37% of falling residents struck their heads upon falling, and of that group, their heads hit the ground (64%), the wall (13%) or furniture (16%). When residents struck their heads on the floor, 87% of head strikes occurred on vinyl or linoleum floors and 13% on carpet.

In falls with head impact and for which researchers had access to incident reports (59 total), a head injury was documented 34% of the time (20 falls). The most common injuries recorded after head strikes were abrasions or lacerations (45%) and hematoma (30%), and 20% of the 20 falls resulted in hospital visits, two for nose fractures and two for head lacerations. No concussions were noted, the researchers wrote.

Their findings, which were published in the Oct. 7 issue of the Canadian Medical Association Journal, show direction of fall and landing position were significantly associated with likelihood of head impact.

“Odds for head impact were greatest for falls initially directed forward and smallest for falls involving a backward landing configuration,” the authors wrote.

While falling, patients tended to rotate their bodies backward, which lowered the risk of head impact, according to the study. Many study participants tried to use their hands to stop the falls; however, this was not significantly associated with rate of head impact. At least one hand or forearm hit the ground in 74% of falls, and in 79% of falls involving head impact. Hand impact was seen in 97% of falls with head impact and an initial forward-falling direction, the study found.

According to study author Stephen Robinovitch, PhD, a professor of Biomedical Physiology and Kinesiology at Simon Fraser University, Burnaby, Canada, and a Canada Research Chair in Injury Prevention and Mobility Biomechanics, recent studies have shown a rapid increase in falls among seniors, particularly those 80 and older.

“It’s a rising trend that is poorly understood,” Robinovitch said in a news release, adding falls are the No. 1 cause of injury and among the 10 most common causes of deaths of older adults in Canada.

“Upper-limb strength (and movement speed) should be assessed carefully in the older adult who presents with a fall-related injury, and adults should be encouraged across their lifespan to engage in exercises to strengthen upper limbs to improve their ability to stop a fall,” the authors wrote.

Future research is needed to determine whether training programs based on martial-arts falling techniques would be beneficial for older adults, according to the study.